36D0331306 CLIA NUMBER - PROMEDICA PHYSICIANS ARROWHEAD FAMILY PRACTICE

Laboratory Demographics

  • CLIA Code: 36D0331306
  • Facility Name: PROMEDICA PHYSICIANS ARROWHEAD FAMILY PRACTICE
  • Facility Address: 660 BEAVER CREEK CIRCLE SUITE 110
    MAUMEE, OH
    ZIP 43537
  • Facility Phone: 419 891-6210
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: JAMES EWRY
  • NPI Number: 1962543702
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 36D0331306
LAB Type Physician Office
Facility Name PROMEDICA PHYSICIANS ARROWHEAD FAMILY PRACTICE
Street 660 BEAVER CREEK CIRCLE SUITE 110
City MAUMEE
State OH
ZIP 43537
Phone 419 891-6210
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/23/2023
Certificate Expiration Date 12/22/2025
Facility Type Physician Office
Lab Director JAMES EWRY

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This page was last updated on: 9/29/2025